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A less invasive single port laparoscopic surgery of transabdominal preperitoneal repair for groin hernia with one needle forceps.

Junko Takita1, Norihiro Masuda1, Norihiro Haga1, Hideo Ogata1, Yuta Shibasaki1, Hiroyuki Kuwano2. 1NHO Utsunomiya National Hospital, 2Gunma University

Introduction: For the transabdominal preperitoneal repair (TAPP) for groin hernia, single port surgery (SPS) has been reported to reduce the abdominal wall damages. To reduce the length of the umbilical scar and to keep the view of triangulation, we use one needle forceps plus SPS.

Patients and Methods: From May 2014 to July 2017, 168 consecutive TAPP patients were retrospectively investigated. There were 139 male and 29 female. We use two 5mm ports (1 for the scope and 1 for the operator’s right hand forceps) through an umbilical multi-channel port and additional 3mm needle instrument is pierced above the pubic bone. A 5mm flexible scope allowed us to keep the triangular formation easily. We studied the safety and usefulness of this method from the viewpoints of operation time and the complications.

Results: Median operation time of single side hernia (135 cases) was 77 min (38-152) and the bilateral case (33 cases) was 139 min (91-269). Five cases needed one or two additional 5mm ports, and one case with severe preperitoneal adhesion due to the previous prostate cancer surgery was converted to open method because of the venous bleeding. Other complications were 2 spermatic cord injury and 3 postoperative seroma that required the percutaneous puncture. Umbilical scars and the pierced needle instrument scars became gradually invisible within 1 or 2 months. There were no incisional hernia nor wound infections in our series.These data was comparable to the conventional laparoscopic hernia repairs.

Conclusions: Operation scars of this method  had better cosmesis than the conventional TAPP or SPS TAPP, and there were no differences between our SPS-TAPP with one needle foerceps and conventional method in operation time and the complication rate. Our method was demonstrated as a less invasive approach for laparoscopic groin hernia repair.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86740

Program Number: P683

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

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